Domestic minor sex trafficking (DMST) is the commercial sexual exploitation of U.S. citizen or lawful permanent resident children. This study explored the identification of DMST victims and their access to crime victim services. Findings suggest an acute lack of awareness or understanding of DMST among professionals likely to come into contact with victims, resulting in failure to identify DMST victims. Because of their misidentification, few DMST victims were accessing victim services. Victim-centered protocols for child sex trafficking criminal cases were lacking, leading to a failure in prosecution of sex traffickers. Professionals reported encountering complex issues, such as DMST victims’ incapacity to break away from traffickers, denial of victimization, high likelihood of flight and revictimization, and reluctance to cooperate with trafficking investigations.